2023 News Archive

12/29/2023 Notification of Annual Benefit Updates 

12/29/2023 Review of Rescinded Prior Authorization Exemptions

12/26/2023 Appropriate Use of Opioids Program to be Retired January 2024

12/26/2023 Utilization Management: Avoid Delays and Denied Claims 

12/22/2023 CPCP006 Preventive Services Policy Update Effective January 1, 2024 

12/21/2023 Update to Claim Editing Changes for Facility Emergency Department Services

12/16/2023 Reminder: Prior Authorizations via eviCore for Blue Cross Group Medicare Advantage Plans

12/16/2023 Electronic Commerce Holiday Schedule Reminder

12/15/2023 Blue Cross Group Medicare Advantage Open Access (PPO)℠: 65 Plus Medicare Advantage Plan (PPO) for Texas A&M University System Retirees

12/15/2023 Update Your Records: New Medicare Advantage Open Access PPO Members and ID Cards

12/15/2023 Prior Authorization Code Changes for Commercial Members Effective April 1, 2024

12/14/2023 Reminder: Serving our Blue High Performance Network® (BlueHPN®)

12/13/2023 Pharmacy Program Updates Quarterly Pharmacy Changes - Part 1: Effective January 1, 2024 updated November 27, 2023

12/13/2023 Remind Our Members about Cervical and Breast Cancer Screenings

12/12/2023 Monitoring Children Using ADHD Medication 

12/11/2023 Hospitals Must Provide Medicare Outpatient Observation Notice 

12/11/2023 Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed

12/08/2023 Prior Authorization Code Changes for Medicare Members, Effective January 1, 2024

12/08/2023 BCBSTX’s Approach to Managing GLP-1 Agonist Medications

12/08/2023 Annual Review: CPCP024 Evaluation and Management (E/M) Coding – Professional Provider Services Update Effective 12/08/2023

12/07/2023 Annual Review: CPCP008 Psychological and Neuropsychological Testing Update Effective 12/07/2023

12/07/2023 CPCP033 Telemedicine and Telehealth/Virtual Health Care Services Policy Update Effective 03/08/2024

12/07/2023 Care Guidelines for Medicare Advantage Members’ Availability and Access Standards

12/06/2023 Oral Oncology Pharmacy Network Transitioned to IntegratedRx™

12/06/2023 CPCP020 Drug Testing Clinical Payment and Coding Update Effective 03/07/2024

12/05/2023 Prior Authorization Code Changes for Commercial Members

12/05/2023 CPCP004 NICU Level of Care Authorization and Reimbursement Policy Update Effective 03/06/2024

12/05/2023 CPCP030 Point-of-Care Ultrasound Updated Effective 03/06/2024

11/30/2023 TRS is Moving Certain Services to Recommended Clinical Review

11/30/2023 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 12/01/2023

11/29/2023  Three New ClaimsXtenTM Rules to be Implemented March 2024

11/29/2023 Advisory on Telemedicine and Telehealth Services – Using Place of Service Codes on Commercial Claims

11/17/2023 FEP® Updates to Prior Approval Requirements and Benefits

11/17/2023 TRS Hospital Claim Analysis as Required by House Bill

11/13/2023 Colorectal Cancer Screenings Goal: 80% in Every Community – “Pulling It All Together"

11/10/2023 Training Resources for Behavioral Health Care 

11/08/2023 Pharmacy Program Quarterly Update, Part 1, Changes Effective January 1, 2024

11/01/2023 Chronic Kidney Disease Management Strategies for Primary Care Providers

10/31/2023 Webinar on Coding for Annual Health Assessments

10/30/2023 Encourage Annual Eye Exams for Members with Diabetes

10/27/2023 See Updates to Claim Editing Changes for Emergency Department Services 

10/26/2023 Category Removals from eviCore and other Updates to Prior Authorization Codes for Medicare Advantage Members, Effective Jan. 1, 2024

10/26/2023 Musculoskeletal, Cardiology Expansion and other Prior Authorization Code Changes for Commercial Members, Effective Jan. 1, 2024

10/24/2023 CPCP027 Inpatient Readmissions Policy Update Effective October 24, 2023

10/24/2023 New BlueApprovRSM Tool Now Expedites Prior Authorization and Recommended Clinical Reviews for Behavioral Health services and more - Attend a Training

10/24/2023 Fee Schedules Update Effective February 1, 2024

10/23/2023 Medicare Advantage Members Transitioning to BCBSTX Kidney Care Program

10/19/2023 See New Enhancements for Behavioral Health Prior Authorizations Effective Nov. 6, 2023

10/18/2023 CPCP006 Preventive Services Policy Update Effective November 1, 2023 

10/18/2023  Reminder: Fee schedule updates

10/18/2023 New CPT Codes for COVID-19 Vaccines and Vaccine Administration

10/16/2023 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Updated Effective 01/15/2024

10/16/2023 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 12/01/2023

10/16/2023 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 10/01/2023

10/11/2023 Behavioral Health Mid-Level Fee Schedule Increase - Medicare Advantage Effective Jan. 01, 2023

10/09/2023 Join Us for a Webinar on Coding for Vascular Disease

10/09/2023 Coordinating Care after Hospital Discharges to Help Reduce the Chances of Readmissions

10/06/2023 Medicare Advantage Behavioral Health Services Update Effective Jan. 01, 2023

10/05/2023 Language Line Supporting Cultural Competence

10/05/2023 Update: Reimbursement Change for Inpatient DRG Claims When Patients Are Transferred Early 

10/04/2023 Introducing Claim Reconsideration Requests via Availity® Essentials 

10/04/2023 Pharmacy Program Quarterly Update, Part 2, Changes Effective October 1, 2023

09/29/2023 CPCP028 Non-Reimbursable, Experimental, Investigational and/or Unproven Services Effective 12/01/2023 Revised

09/28/2023 CPCP028 Non-Reimbursable, Experimental, Investigational and/or Unproven Services Update 10/01/2023

09/28/2023 Overcoming Barriers to Colorectal Cancer Screenings

09/28/2023 Survey Assesses Medicare Advantage Members’ Health Outcomes

09/28/2023 CPCP006 Preventive Services Policy Update Effective October 1, 2023 

09/28/2023 2024 Expansion Blue Cross Medicare Advantage

09/28/2023 Supporting Quality Care During Breast Cancer Awareness Month 

09/20/2023 MyBlue HealthSM Network Expansion

09/07/2023 New Location in Availity® to Access Prior Authorization Exemption Communications as of Sept.7, 2023

09/07/2023 Update: Ground and Air Ambulance Overpayment Error 

09/05/2023 ClaimsXten™ Quarterly Update Effective Dec. 4, 2023  

09/01/2023 Notifications for Prior Authorization Exemptions for Jan. 1 to June 30, 2023 Review Period

09/01/2023 New BlueApprovRSM Tool Expedites Prior Authorization and Recommended Clinical Review for some Medical Surgical services — Attend a Training

08/31/2023 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 12/01/2023

08/29/2023 Updates to Clinical Practice and Preventive Care Guidelines

08/23/2023 BlueCard® Program Reminder

08/21/2023 Physician Performance Insight Reports are Now Available!

08/17/2023 Removal of Select Medication List

08/15/2023 Reimbursement Change for Inpatient DRG Claims When Patients Are Transferred Early

08/11/2023 Submitting Claims for Infertility Services 

08/08/2023 Reminder - Notice of Prior Authorization Exemptions Rescission 

08/03/2023 See New Enhancements for Behavioral Health Prior Authorizations

08/02/2023 Shared Decision-Making Aids Can Help Guide Care Choices

07/31/2023 Future Blue Cross Blue Shield Association Provider Performance Program

07/31/2023 Pharmacy Program Quarterly Update, Part 1, Changes Effective October 1, 2023

07/28/2023 Reporting On-Demand via Availity® Essentials is Now Named Provider Claim Summary

07/24/2023 Update to Prior Authorization Codes for Medicare Members, Effective Oct. 1, 2023

07/24/2023 Claim Editing Changes for Emergency Department Services Coming Nov. 1, 2023

07/24/2023 Revised CPCP003 and New CPCP042 for Emergency Department Evaluation and Management Services Coding for Facility and Professional Services, Effective 10/25/2023     

07/21/2023 Designating Prior Authorization Requests as “Urgent”

07/21/2023 Reminder – Physician Performance Insight (PPI) Reports are Coming Soon!

07/20/223 Free Tools & Resources Available via Availity® Essentials

07/19/2023 Colorectal Cancer Screening Options and Statistics: Get the Conversation Started Today

07/18/2023 Reminder: Prior Authorization Exemption Communication Method Preference

07/18/2023 Introducing Smart RxAssist via HealthSmartRx®

07/17/2023 2022 Excutive Summary and 2023 Goals

07/17/2023 CPCP031 Trauma Activation - Facility Services Updated Effective 10/18/2023

07/11/2023 Provider Depression Disorder Prescribing

07/10/2023 Update to Prior Authorization Codes for Commercial Members, Effective Oct. 1, 2023 

07/07/2023 Pharmacy Program Quarterly Update, Part 2, Changes Effective July 1, 2023

07/06/2023 Webinar on Coding for Morbid and Severe Obesity

07/05/2023 In-Home Test Kits for Colorectal Cancer Screening

06/30/2023 Antidepressant Medical Management

06/30/2023 CPCP014 Global Surgical Package – Professional Providers Updated Effective 10/01/2023

06/29/2023 Update to Prior Authorization Exemption Clinical Guidelines

06/29/2023 Reminder - Notice of Prior Authorization Exemptions Renewal Review

06/29/2023 CPCP006 Preventive Services Policy Updated Effective  07/01/2023 

06/27/2023 CPCP021 Laboratory Panel Billing Updated Effective 09/28/2023

06/22/2023 Physician Performance Insight (PPI) Reports - Coming Soon!

06/14/2023 Medicare Advantage Annual Wellness Visits: Webinar and Resources

06/13/2023 More Access for Medicare Patients and Providers

06/07/2023 New Availity® Eligibility & Benefits Experience  

06/06/2023 Provider Rights and Responsibilities

06/06/2023 Member Rights and Responsibilities

06/06/2023 New Clinical Payment and Coding Policy CPCP041 Sepsis Policy Effective 09/06/2023

06/05/2023 Catch Up on Routine Vaccines and Well-Child Visits

06/02/2023 ClaimsXtenTM Announces Software Version Upgrade 

06/01/2023 Additional Changes to Prior Authorization Codes for Commercial Members, Effective July 1

06/01/2023 Update of CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update for 04/01/2023 & 07/01/2023 

06/01/2023 CPCP011 Applied Behavioral Analysis Updated Effective 09/01/2023

05/31/2023 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 09/01/2023

05/31/2023 CPCP001 Observation Services Policy Updated Effective 09/01/2023

05/30/2023 Notice of Prior Authorization Exemptions Renewal Review

05/25/2023 Additional Changes to Prior Authorization Codes for Medicare Members, Effective July 1, 2023

05/22/2023 New Clinical Payment and Coding Policy CPCP039 Outpatient Facility Service(s) Overlapping During an Inpatient Stay Effeective 09/01/2023

05/22/2023 Earn Continuing Education Credit: Webinar on Avoiding Inappropriate Antibiotic Use

05/17/2023 Annual Review: CPCP026 Therapeutic Prophylactic Diagnostic Injection Infusion

05/17/2023 CPCP0012 Hernia Repair Updated Effective 08/18/2023

05/16/2023 The Need for Better, Improved Continuity and Coordination of Care 

05/15/2023 Medical Policy Updates

05/15/2023 CPCP0013 Increased Procedural Services (Modifier 22) Effective 08/15/2023

05/15/2023 CPCP034 Unbundling Policy – Professional Providers Effective 08/15/2023

05/10/2023 More Outpatient Surgery Codes With Increased Reimbursement When Performed in Ambulatory Surgery Center

05/10/2023 Medical Records Reminder for Out-of-Area Medicare Advantage Members

05/10/2023 ClaimsXten™ Quarterly Update Effective August 21, 2023  

05/09/2023 Language Line Supporting Cultural Competence

05/09/2023 Colon Cancer Screenings Goal: 80% In Every Community

05/04/2023 Medicare Advantage Annual Wellness Visit: Webinar and Resources

05/04/2023 Update to Prior Authorization Codes for Medicare Members, Effective July 1, 2023  

05/02/2023 Helping Our Members Manage Diabetes

04/28/2023 Pharmacy Program Quarterly Update, Part 1, Changes
Effective July 1, 2023

04/18/2023 Annual Review: CPCP024 Evaluation and Management Coding – Professional Provider Services Effective 04/20/2023

04/17/2023 How to Correctly Use Our Claim Review Form

04/17/2023 New CPCP038 Outpatient Services Prior to an Inpatient Admission, Three-day Payment Policy Effective 08/01/2023

04/13/2023  Webinar on Coding for Chronic Kidney Disease

04/12/2023  Behavioral Health Consultations During Hospitalization Can Improve Outcomes

04/11/2023 Ground and Air Ambulance Overpayment Error 

04/06/2023 Pharmacy Program Quarterly Update, Part 2, Changes Effective April 1, 2023

04/04/2023 Track Care Visits During and After Pregnancy 

04/03/2023 Update to Prior Authorization Codes for Commercial Members, Effective July 1, 2023

03/31/2023 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 07/01/2023

03/28/2023 CPCP006 Preventive Services Policy Update Effective April 1, 2023 

03/24/2023 Update to CPCP010 Anesthesia Services Effective 06/26/2023

03/24/2023 Annual Review: CPCP020 Drug Testing Clinical Payment and Coding Policy Effective 03/27/2023

03/24/2023 New CPCP040 Physical Medicine and Rehabilitation Services Effective 06/26/2023

03/24/2023 Update to CPCP016 Chiropractic Care Services Effective 06/26/2023

03/24/2023 Update to CPCP023 Modifier Reference Effective 06/26/2023

03/24/2023 CPCP007 Implant Payment and Coding Policy Retired 03/31/2023

03/15/2023 Changes to CPCP027 Inpatient Readmissions Policy Effective 07/01/2023

03/13/2023 Screening and Follow-Up Care for Maternal and Mental Health 

03/13/2023 Caring for Substance Use Disorders

03/13/2023 Monitoring Children Using ADHD Medications

03/10/2023 AIM Specialty Health Changes Its Name to Carelon Effective March 1, 2023

03/09/2023 Medicare Advantage Annual Health Assessment Incentive FAQs – 2023

03/09/2023 Notifications for Prior Authorization Exemptions for July 1 to Dec. 31, 2022 Review Period

03/08/2023 Annual Review: TXCPCP003 Surgical and Non-Surgical Services Policy Update Effective March 9, 2023

03/07/2023 Earn Continuing Education Credit through Webinar on Opioids 

03/07/2023 Earn Continuing Education Credit through Webinar on Maternal Mental Health

02/28/2023 CPCP006 Preventive Services Policy Update Effective March 1, 2023 

02/27/2023 Pharmacy Program Quarterly Update, Part 2:
Changes Effective Jan. 1, 2023

02/22/2023 Prior Authorization and Claim Reconciliation for Neonatal Intensive Care Unit Services Effective 04/16/2023 

02/21/2023 New for 2023: Specialty Pharmacies Added In-Network

02/21/2023 CPCP003 Emergency Department Evaluation and Management (E/M) Services Coding – Facility Services effective 02/22/2023

02/16/2023 CPCP022 Pneumatic Compression Devices – Outpatient Use Update – Effective 05/17/2023

02/16/2023 Help Close Gaps in Care for Group Medicare Advantage Members

02/15/2023 CPCP017 Wasted/Discarded Drugs and Biologicals Policy – Effective 05/16/2023

02/14/2023 Pharmacy Program Updates: Quarterly Changes Effective April 1, 2023- Part 1

02/10/2023 Verify Your Directory Details Every 90 Days

02/09/2023 New Support Program for Members with Kidney Disease

02/08/2023 Survey to Assess Medicare Advantage Members’ Experiences

02/03/2023 Closing Gaps in Colon Care

02/03/2023 Earn Continuing Education Credit through Webinar on Bipolar Disorder

02/02/2023 Quality Care: Screening for Depression

02/02/2023 Cultural Awareness Webinars: Earn Continuing Education Credit

01/30/2023 Prior Authorization Exemption Communication Method Preference

01/30/2023 Update to Prior Authorization Codes for Medicare Members, Effective April 1, 2023

01/20/2023 How to Identify UT CARETM Members

01/17/2023 Correction - Prior Authorization Codes for Commercial Members Updated Effective April 1, 2023

01/09/2023 2022 Annual HEDIS®/QRS Reports

01/06/2023 Predetermination is Changing to Recommended Clinical Review

01/06/2023 Supporting Heart Health Equity

01/04/2023 Annual Review: CPCP036 Paravertebral Facet Injection Procedure Coding & Billing Policy Update Effective 01/06/2023

01/04/2023 Annual Review: CPCP0019 Home Infusion Update Effective 01/05/2023

01/04/2023 CPCP026 Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding Update Effective 04/05/2023

01/03/2023 ClaimsXten™ Quarterly Update Effective April 17, 2023